NCT05537376

Brief Summary

Suicide is a major public health concern, particularly among Veterans with serious mental illness (SMI, i.e., psychotic disorders or bipolar disorders). Wellness Recovery Action Plan (WRAP) is a well-established evidence-based practice for those with SMI that centers on identifying warning signs of mental illness, developing wellness tools for functional independence, planning for day-to-day effective living within one's community, and building an action plan to create a valued life worth living. This proposed study will refine and pilot SUicide Prevention by Peers Offering Recovery Tactics (SUPPORT), a novel integrated recovery program that is an adaptation of peer-delivered WRAP for Veterans with SMI. In SUPPORT, a Peer Specialist leads a Veteran at increased risk for suicide through recovery planning that is tailored to the Veteran's suicidal experiences with cognitive learning strategies to enhance safety plan recall and improve functioning.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
69

participants targeted

Target at P50-P75 for not_applicable

Timeline
18mo left

Started Sep 2023

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress64%
Sep 2023Oct 2027

First Submitted

Initial submission to the registry

September 7, 2022

Completed
6 days until next milestone

First Posted

Study publicly available on registry

September 13, 2022

Completed
12 months until next milestone

Study Start

First participant enrolled

September 12, 2023

Completed
3.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 15, 2026

Expected
11 months until next milestone

Study Completion

Last participant's last visit for all outcomes

October 31, 2027

Last Updated

August 7, 2025

Status Verified

August 1, 2025

Enrollment Period

3.3 years

First QC Date

September 7, 2022

Last Update Submit

August 5, 2025

Conditions

Outcome Measures

Primary Outcomes (2)

  • Feasibility of recruitment and retention

    Recruitment and retention is determined by the number of participants who were initially contacted, consented, completed baseline data, and completed follow-up data.

    Through study completion, an average of 4 years

  • Acceptability of SUPPORT as measured by the Client Satisfaction Questionniare-8 (CSQ-8)

    The CSQ-8 brief survey has been used extensively in VA and non-VA settings to assess overall satisfaction with care, and it has excellent internal consistency (0.93). An overall score" is calculated by summing the participant's rating score for each scale item. Scores range from 8 to 32, with higher values indicating higher satisfaction.

    At the end of the intervention, an average of 4-weeks

Secondary Outcomes (2)

  • Change in the Scale for Suicide Ideation (SSI)

    Baseline, 2-weeks, 4-weeks, 3-month follow-up

  • Change in Recovery Assessment Scale-41

    Baseline, 2-weeks, 4-weeks, 3-month follow-up

Study Arms (2)

SUPPORT

EXPERIMENTAL

Veterans receiving SUPPORT will be offered all modules of the intervention via weekly, 50-minute sessions with a Peer Specialist. Following the completion of a mental health evaluation by a licensed professional, the Peer Specialist leads the Veteran who is at risk for suicide through recovery planning that is tailored to the Veteran's suicidal experiences with cognitive learning strategies to enhance recall of the Veteran's safety plan and improve recovery.

Behavioral: SUicide Prevention by Peers Offering Recovery Tactics

ESC

NO INTERVENTION

The enhanced standard care (ESC) condition contains the elements of standard practice suicide prevention delivered at VHA, which include: 1) suicide risk assessment, 2) VA Safety Planning Intervention, 3) timely referral to VA mental health outpatient care, and 4) Suicide Prevention Coordinator follow-up contacts. It is enhanced due to the contact with the research study.

Interventions

Following the completion of a comprehensive mental health evaluation by a licensed VA provider, which includes a suicide safety plan, if a Veteran is having active thoughts of suicide or made a suicide attempt in past three months, they may be eligible for SUPPORT. In SUPPORT, the Peer Specialist and Veteran co-create a personalized suicide-focused recovery plan (SUPPORT Plan) in flexible, 50-minute weekly encounters. The SUPPORT Plan includes modules that focus on valuing recovery, building a hope kit and daily plan, setting recovery goals, and looking ahead to enhance the Veteran's safety plan. Learning strategies are incorporated into each module to promote salience and recall of intervention material. The Peer Specialist works closely with the Veteran's treatment team and uses the most recent safety plan in the Veteran's chart to help complete the SUPPORT Plan as well as reinforce the usage of the Veteran's safety plan.

Also known as: SUPPORT
SUPPORT

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Veterans who report present suicidal ideation (i.e., Columbia-Suicide Severity Rating Scale (C-SSRS) \> 2 ("Active thoughts of killing oneself") in past 1 month and/or a suicide attempt in the prior 3 months as identified by the C-SSRS
  • Current SMI diagnosis (i.e., schizophrenia and other psychotic disorders, mood disorders with psychotic features, bipolar disorders)
  • Capable of informed consent via the University of California San Diego Brief Assessment of Capacity to Consent (UBACC)
  • Certified Peer Specialist employed at VA San Diego Healthcare System (VASDHS) in the Mental Health Care Line (individuals must demonstrate competency in basic suicide screening and referral procedures to be certified)
  • years of experience post certification as a Certified Peer Specialist
  • Interest in being trained in SUPPORT
  • Provide verbal or written consent for the research staff to discuss ability to participate in the study with the Peer Specialist's direct clinical supervisor
  • Direct clinical supervisor agreement to allow the Peer Specialist to participate. This includes the Peer Specialist's direct clinical supervisor agreement to allow the Peer Specialist time as part of their current scope of practice to 1) participate in the full day (8-hour) SUPPORT training, 2) participate in weekly 1-hour group supervision for the duration of the Peer Specialist's time in the study, and 3) take on a case load of at least one SUPPORT Veteran at a given time.

You may not qualify if:

  • Cannot complete the assessment battery
  • Current intoxication requiring immediate detoxification or outpatient plan directed specifically to residential substance use disorder (not mental health) services
  • Imminent psychiatric hospitalization

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

VA San Diego Healthcare System, San Diego, CA

San Diego, California, 92161-0002, United States

RECRUITING

Related Publications (2)

  • Chalker S, Carter J, Imai Y, Depp C, Chinman M. A Recovery-Oriented Suicide Prevention Program Led by Peer Specialists for Veterans With Serious Mental Illness: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc. 2025 Aug 20;14:e66182. doi: 10.2196/66182.

  • Chalker SA, Serafez J, Imai Y, Stinchcomb J, Mendez E, Depp CA, Twamley EW, Fortuna KL, Goodman M, Chinman M. Suicide Prevention by Peers Offering Recovery Tactics (SUPPORT) for US Veterans With Serious Mental Illness: Community Engagement Approach. J Particip Med. 2024 May 23;16:e56204. doi: 10.2196/56204.

MeSH Terms

Conditions

Psychotic DisordersBipolar DisorderSuicidal IdeationSuicide, Attempted

Interventions

Palliative Care

Condition Hierarchy (Ancestors)

Schizophrenia Spectrum and Other Psychotic DisordersMental DisordersBipolar and Related DisordersMood DisordersSuicideSelf-Injurious BehaviorBehavioral SymptomsBehavior

Intervention Hierarchy (Ancestors)

Patient CareTherapeuticsHealth ServicesHealth Care Facilities Workforce and Services

Study Officials

  • Samantha A Chalker, PhD

    VA San Diego Healthcare System, San Diego, CA

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Samantha A Chalker, PhD

CONTACT

Colin A Depp, PhD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Veterans receiving SUPPORT will be offered all modules of the intervention via weekly, 50-minute sessions with a Peer Specialist. Following the completion of a mental health evaluation by a licensed professional, the Peer Specialist leads the Veteran who is at risk for suicide through recovery planning that is tailored to the Veteran's suicidal experiences with cognitive learning strategies to enhance recall of the Veteran's safety plan and improve recovery.
Sponsor Type
FED
Responsible Party
SPONSOR

Study Record Dates

First Submitted

September 7, 2022

First Posted

September 13, 2022

Study Start

September 12, 2023

Primary Completion (Estimated)

December 15, 2026

Study Completion (Estimated)

October 31, 2027

Last Updated

August 7, 2025

Record last verified: 2025-08

Data Sharing

IPD Sharing
Will not share

Locations